Mindspective

Tuesday, 17 May 2011

Research repeatedly finds evidence that computer games can be addictive and have negative effects on mental and physical health. Some benefits can be noted, in terms of improved hand and eye coordination, for example, but there is a dark side, too, and maybe the health costs outweigh the benefits.

Research from the University of Medical Science at Kerman, Iran, adds to the growing body of evidence that computer games do affect the mental and physical health of students.

In a study of 564 students at public guidance schools in Isfahan, the researchers (Eshrat Zamani, Maliheh Chashmi, and Nasim Hedayati) found evidence of impaired social functioning, sleeplessness and anxiety among those habitually playing computer games.

Computer games provide the thrill of winning and achieving new levels, a sense of wellbeing and growing proficiency in meeting the challenge of the games. They stimulate the emotions as the player experiences anger and frustration, triumph, aggression and a rush of adrenaline that can become addictive. A game clicks over from being an entertaining diversion to being an addiction when the player begins to neglect other normal functions of life in order to keep on playing or finds that they experience withdrawal symptoms such as irritability when they have not had a fix. Risk behaviours such as getting into debt, ignoring responsibility or depriving oneself of sleep are also characteristic of addictions.

Sitting in front of a computer screen and playing games has a number of effects that can account for the findings of the research.

Social Isolation
Most computer games are played alone. Instead of interacting with their peers and growing social skills, players are interacting with a machine and giving increasing amounts of time to gaming activity.

Physical Effects
Sitting in one position for a prolongued period affects posture and the muscular-skeletal system, leading to reported aches and pains. Neglecting normal diet and hygiene in order to give more time to playing computer games can also cause reported physical symptoms.

Stress
Playing computer games constantly invokes the sympathetic nervous system, heart and respiration rates increase and players report feelings of anxiety while gaming. It is stressful for the human fight/flight response to be constantly aroused by the simulation of danger that many games rely on.

It is common sense to say that it can’t be healthy to spend hours at a time playing computer games, but this point of view appear to be increasingly supported by scientific findings.

Source:
Zamani et al (2009) “Effect of Addiction to Computer Games on Physical and Mental Health of Female and Male Students of Guidance School in City of Isfahan” in Addiction and Health vol 1, no 2. P.98-105.

Thursday, 13 January 2011

Canadian researchers at Montreal Neurological Institute and Hospital have been unpacking the neurochemical dimension to the pleasure of listening to music. The findings of the research are thought to be the first of their kind, confirming that abstract pleasures such as music have the same rewarding effect on the mind and body as more tangible stimuli such as food and sex. According to Dr Robert Zatorre the study provides, "neurochemical evidence that intense emotional responses to music involve ancient reward circuitry in the brain".

Even the anticipation of listening to pleasurable music begins to stimulate dopamine activity and can be detected through PET and fMRI brain imaging techniques. In fact, changes in skin conductance, heart rate, breathing and temperature account quite literally for the "chill" factor experienced in response to music we enjoy - it really does send shivers down the spine.

The mechanisms involved in our emotional response to music are shown to be the very same networks that humans have developed to reinforce the behavior that is necessary for survival. Researchers also noted that the effect key aesthetic ideas in what makes music work, such as "tension and resolution", can be observed on the neurological level as a piece of music unfolds.

Instead of heading for the fridge for a bite of comfort food, perhaps we could indulge ourselves in a favourite piece of music and reap the same psychological rewards without the calorific burden.

Tuesday, 26 October 2010

Flexible and targeted follow up of patients with depressive symptoms need not stretch the resources of a doctor's surgery but could massively improve outcomes in primary care according to new research from University of Michigan Health System.

Traditionally, it may be many months before someone who is seen ever so briefly by a doctor will have further contact from a health professional, by which time the condition may well have worsened. It is not enough to simply signpost a patient to some self-help resources and leave them to get on with it. A simple phone call and the opportunity to self-monitor were among the measures shown to improve the likelihood of symptoms being in remission eighteen months later.

The study, lead by Professor Michael Klinkman, M.D., M.S at the University of Michigan Medical School, compared 728 referred patients who received the extra interventions against a control group of 78 who got the traditional mode of treatment. Nearly twice as many (49.2%) of the treated group were in remission after 18 months, as in the control group (27.3%).

Professor Kinkman points out that the study included patients with “chronic issues who have had multiple depressive episodes in the past,” who are notoriously difficult to treat, and still saw an improvement in outcomes that was persistent over time.

Once again it is really no surprise to learn that more engagement and involvement and a more human touch from healthcare practitioners results in improvements to the success of the care; but the take-home message of this study is that it does not take very much more effort and input to almost double the efficacy of that care. This is encouraging and should have implications for the treatment of other disorders, too.

The study is published under "Long-Term Clinical Outcomes of Care Management for Chronically Depressed Primary Care Patients: A Report From the Depression in Primary Care Project." in Annals of Family Medicine, September/October 2010.

Wednesday, 13 October 2010

In a profession where the bottom line is the "therapeutic relationship", it is not surprising that a new study shows that psychiatric nurses are highly involved in the care of patients but feel that they would see better outcomes from more involvement and more time with patients.

The results of the survey, sponsored by Janssen®, and including a total of 255 nursing professionals, are due to be discussed this week at the American Psychiatric Nurses Association Annual Meeting in Louisville, KY. They show that almost half of the professionals surveyed identify that they do not have enough time to be involved in the provision of care. Half the participants also desired more participation in the treatment teams and the vast majority of nurses (90%) felt they had a valuable role to play in facilitating communication between patients and physicians. This appears to imply that nurses feel somewhat excluded from some levels of decision making and involvement and have a much greater role to play and more to offer.

Nurses have a high level of contact with patients, traditionally being concerned with the coal-face of care delivery on a 24 hour basis. They will often have insights and a level of relationship and rapport with a patient that can significantly contribute to team decision making and the outcome of care. In America, over 90,000 psychiatric nurses in practice represent a flexible and dynamic work force with a basic skill set that includes working with a wide range of individuals from all backgrounds, assessing mental health needs, and implementing individualised plans of care.

According to this survey, it is the time that nurses actually spend with patients that is believed to be very important in a good overall level of patient satisfaction. Nurses clearly value their roles highly, believe they are making a significant contribution to patient experience and outcomes and would relish the opportunity to be more involved at every level of developing and delivering care for their patients.